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Individual

DR. KHAIRUNNISSA JOOMA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP/PMHNP-BC/LPC

Contact information

Practice address
9041 EXECUTIVE PARK DR STE 275B, KNOXVILLE, TN 37923-4621
(865) 338-5384
(865) 338-5383
Mailing address
91 HARBOR POINTE WAY, KNOXVILLE, TN 37922-5154
(865) 684-0900

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC 1953
TN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APN0000013348
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5441854
TN
01
P00967911
RAILROAD MEDICARE
TN
Enumeration date
07/09/2006
Last updated
12/06/2024
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